A randomized controlled clinical study to evaluate the efficacy of tilanala pratisaraneeya kshara in the management of abhyantara arshas (2nd and 3rd degree internal haemorrhoids)

Arshas can be rationally correlated to haemorrhoids in Contemporary science. The term Arshas refers to illness which tortures the person like an enemy. Acharya Vagbhata describes Arshas as Mamsankura’s which is protruding out and obstructing the Guda marga1. As the age advances, the incidence rate increases in both male and female and atleast 50% are affected over the age of 50 years2. The prevalence rate of Haemorrhoids is 4.4% in the world, in about 10 million people3. The modern treatment modalities in internal haemorrhoids are Sclerotherapy, Rubber band ligation and Cryosurgery. Each procedure carries it’s own complications4. The Arshas which are Mrudu, Prasrutha, Avagadha and Uchrita should be treated by Pratisaraneeya Kshara5. Acharya Sushruta mentioned Kshara mahatva as Chedya, Bhedya, Lekhya, Tridoshagna6 and Kshara karma has a minimal invasive technique. Therefore, use of Kshara in the management of Arshas is the need of the hour. The drug Tilanala has been mentioned as one among the Kshara Panchaka in Kaiyadeva Nighantu7. Tilanala is annual plant which is available in all seasons8, where as Apamarga is seasonally available. Tilanala is easily available and cost effective. Tilanala is Madhura, Kasaya, Tikta, Katu rasa pradhana, Ushna virya, Madhura vipaka and it possesses the qualities of Vatahara, Vranahara, Sulaprashamana, Tridoshashamaka, hence it can be taken in Abhyantara Arshas (2nd & 3rd Degree Internal Haemorrhoids). Here an attempt is made to evaluate the efficacy of Tilanala Pratisaraneeya Kshara over Apamarga Pratisaraneeya Kshara in the management of Abhyantara Arshas (2nd & 3rd Degree Internal Haemorrhoids).